Comparison for the efficacy and safety of time-to-isolation protocol and conventional protocol of cryoballoon in the tre
- PDF / 965,706 Bytes
- 10 Pages / 595.276 x 790.866 pts Page_size
- 35 Downloads / 198 Views
Comparison for the efficacy and safety of time-to-isolation protocol and conventional protocol of cryoballoon in the treatment of atrial fibrillation: a meta-analysis and systematic review Guolin Liu 1,2 & YuanLi Wang 1,2 & Xin Xu 1,2 & Jie Tian 1,2 & Tiewei Lv 1,2 Received: 16 August 2020 / Accepted: 28 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Cryoballoon (CB) has been widely utilized in the treatment of drug-refractory atrial fibrillation (AF), but the balance point between efficacy and safety has been unclear. The protocol based on the time-to-isolation (TTI) was expected to provide patients with individualized ablation strategies. Methods All studies up to June 2020 comparing the CB of TTI-based protocol (TTIP) and conventional protocol (ConP) in PubMed, Embase, and Cochrane Library databases were searched. The pooled OR or SMD with 95% CIs for each outcome were calculated with inverse-variance random effect model. The Egger method was used to evaluate the publication bias and the subgroup analysis was conducted according to the type of atrial fibrillation. Results Six studies enrolling a total of 1770 patients with drug-refractory AF were included. The pool real-time recording of pulmonary veins potential was 71% (95% CI: 61 ~ 81%, I2 = 97.9%) and a similar incidence of freedom from ATs after 1 year (OR: 1.12; 95% CI: 0.86 ~ 1.46, I2 = 0.0%, P = 0.481) was observed between two protocols. No difference was observed in complications (OR: 0.67; 95% CI: 0.43 ~ 1.04, I2 = 0.0%, P = 0.717) and phrenic nerve palsy (OR: 0.70; 95% CI: 0.37 ~ 1.35, I2 = 0.0%, P = 0.807). TTIP could significantly decrease the CB freezes per patient (SMD: − 2.44; 95% CI: − 4.46 to approximately − 0.41; I2 = 99.5%, P = 0.00) and shorten the cryotherapy application time (SMD: − 3.04; 95% CI: − 4.18 to approximately − 1.89; I2 = 97.4%, P = 0.00), procedure time (SMD: − 1.51; 95% CI: − 2.08 to approximately − 0.94; I2 = 95.4%, P = 0.00), and fluorescence time (SMD: − 0.70; 95% CI: − 1.25 to approximately − 0.15; I2 = 95.7%, P = 0.00). Conclusion TTIP is safe and effective and it opens a new chapter in the field of individualized protocol of CB for patients with AF. Keywords Time-to-isolation . Cryoballoon . Atrial fibrillation . Pulmonary vein isolation
1 Introduction
This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10840-020-00890-z) contains supplementary material, which is available to authorized users. * Tiewei Lv [email protected] 1
Department of Cardiology; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation base of Child development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China
2
Chong
Data Loading...
